What expectant mothers don't expect

Nadine Marie Christie gave birth to her two children in the same sunlit room she was born in 24 years ago.

Janet Eastman

Nadine Marie Christie gave birth to her two children in the same sunlit room she was born in 24 years ago.

Then and now, the arrivals were as natural as modern times allow, with few interruptions by medical staff. Afterward, mom, dad and baby slept in the room together and later spent quiet time in the garden.

These were not home births. They took place inside Ashland Community Hospital, which has Oregon's longest-operating, hospital-based alternative birth center.

In this intimate space, a mother-to-be chooses whether she will be standing, sitting, kneeling, on a bed or in a whirlpool tub filled with warm water when her baby is born, and if a midwife or doula is by her side.

This customized approach has been the cornerstone of the center since it opened in 1971, says director Lorraine Florio.

"Birthing in the U.S. has become medicalized, crazy, but not here," says Florio, a certified nurse midwife. "This is one of the sanest places to have a baby."

Across the U.S., doctors' offices and hospitals have become marketing centers pushing pricey ultrasounds and brands of infant formula and diapers, according to a new book by Ashland author Jennifer Margulis.

In "The Business of Baby: What Doctors Don't Tell You, What Corporations Try to Sell You, and How to Put Your Baby Before Their Bottom Line," published by Scribner, Margulis writes about birthing procedures that boost profits, foreskins being sold to the beauty and artificial skin industry, and other claims that may shock parents.

Margulis, a mother of four who appeared on PBS Frontline's documentary "The Vaccine War" in 2010 to debate the value of vaccinations, says she is "motivated to empower women to make good choices about health care" and to ask them to not blame themselves if they feel they failed by not being able to have a natural birth or breastfeed.

"We have a system that makes it more difficult to succeed naturally," says Margulis, 43, who has published three other baby-related books. "No one makes money off a woman breastfeeding or by suggesting she eat healthy food instead of taking prenatal vitamins."

Margulis spent 10 years researching the topic — the 350-page book has 62 pages of reference notes — and three years writing "The Business of Baby," which covers issues and costs from pregnancy and childbirth through the first year of life.

She discovered that the U.S. has among the highest maternal and infant mortality rates in the industrialized world. That babies were once potty trained by 18 months but disposable diaper makers promote the need to keep children in diapers until they are 3 years old or older. And that having a baby today is expensive.

At the end of each chapter, she lists costs. The average charge in the U.S. for a cesarean birth is $51,000, vaginal birth in a hospital is $32,000, homebirth is $4,500 and an unassisted homebirth is $15.90.

Deborah Gordon, a family physician practicing integrative medicine at Madrona Homeopathy in Ashland, was one of dozens of doctors, nurses, midwives, corporate spokespeople, scientists and parents interviewed for the book.

Gordon, who writes for www.DrDeborahMD.com, says, "No other natural part of life is quite so medically supervised as birth is in the U.S."

"The Business of Baby," which was released in April, has received an endorsement from author and midwife Ina May Gaskin, who calls it a "searing and well-researched exposť" that "points the way to rational, health-based decision-making."

Margulis is traveling the country on a promotional tour and will have a book signing at 11 a.m. Saturday, April 27, at Barnes and Noble in Medford and at 7 p.m. Thursday, May 2, at Bloomsbury Books in Ashland.

During an interview in Ashland, Margulis said that her first child, a girl now 13, was born in a hospital while the other three — ages 12, 9 and 3 — were born with the help of a nurse and midwife or at home with just her husband, James di Properzio.

"I wasn't a hero trying to prove anything," says Margulis. "We just wanted gentle, peaceful births, which became some of the most amazing experiences of my life."

On Wednesday, as Nadine Marie Christie held her 2-day-old daughter, Rose Marie, in her room at the Ashland Community Hospital Birth Center, she joked that her husband, Adam, was more exhausted than she was.

He had just driven 850 miles to Olympia, Wash., and straight back so he could sign a form that would grant him a 10-day paternity leave from the Army.

Adam Christie offered a loopy grin and said he liked sleeping at the center, which has a birthing bed for his wife and either a long cushioned bay window seat or an extra bed for him to lay his head. Four years ago, their son, James Asher, was born right here.

Unlike some hospitals, there are no giveaway bags of baby goodies supplied by brand-name companies at the Birth Center. Florio says she buys unmarked diapers and formula, and doesn't allow salespeople to bring the staff candy to sweeten them up.

The only brand items sold in a tiny glass case near the entrance are a Bravado nursing bra and a book on vaccinations, "the counter argument to the people who oppose them," says Florio, who has worked here as a nurse-midwife since 1981 and has been its director since 2000.

On a tour through the center, she explains that a whirlpool tub relaxes women in labor. In another private room is a deep, water birth tub that also eases gravity's pull on a body. Near it is a large, inflated stability ball that is comfortable to sit on during contractions.

Mothers-to-be fill out a birthing plan and detail what they'd like, down to the music, pampering items such as massage oil and natural juices, and whether they would like children, a photographer or others in the room.

Since 1995, the center has provided doulas to assist obstetrical nurses and doctors.

Most moms here request dim lights, soft voices, no pain medication, skin-to-skin contact after the birth and that the father cut the umbilical cord after it stops pulsing, says Florio, who sees about 300 newborns a year.

Here, too, babies are not instantly bathed or have the mucus suctioned from their noses, since Florio says evidence shows that these natural fluids benefit the baby. "Doing less is usually best for babies," she says.

There isn't much to see in the so-called nursery: a rocker and one newborn bassinet. "The babies sleep in their parents' room," says Florio. Babies delivered by cesarean section are united with their mothers in the recovery room.

In the nursery, there is equipment if a baby needs emergency or extra support. "We realize that birth is a normal event," says Florio. "But we are ready for the rare occasion when assistance is needed."

Most insurance pays for mother and child to stay 48 hours after a natural birth, but Florio says many moms ask to be released after 24 hours.

Before they leave, Florio and her staff offer them a birth certificate worksheet. She says parents should be able to check a box that they don't want their information shared with companies, so they won't receive calls or emails from marketers.